经皮椎体成形术联合小针刀松解治疗骨质疏松性胸椎压缩性骨折合并肋间痛的疗效观察

Percutaneous vertebroplasty combined with small needle knife release for intercostal pain after surgery of osteoporotic vertebral compression fracture:An observational study

目的观察经皮椎体成形术(PVP)联合小针刀松解治疗骨质疏松性胸椎压缩性骨折(OVCF)合并肋间痛的临床疗效。方法将63例OVCF合并肋间痛患者按照随机数字表法分为2组,对照组28例单纯予PVP治疗,治疗组35例予PVP联合小针刀松解治疗。比较2组术前及术后3天、1个月、6个月胸背及肋间疼痛变化情况,采用疼痛视觉模拟评分(VAS)进行评价;比较2组术前及术后3天、1个月、6个月腰椎功能变化情况,采用Oswestry功能障碍指数(ODI)进行评价。结果与本组术前比较,治疗组术后3天、1个月、6个月胸背及肋间疼痛VAS均降低(P<0.05),对照组术后3天、1个月、6个月胸背VAS及术后6个月肋间VAS均降低(P<0.05),且治疗组术后3天、1个月肋间疼痛VAS均低于对照组(P<0.05),2组术后3天、1个月、6个月胸背疼痛VAS及术后6个月肋间疼痛VAS比较差异均无统计学意义(P>0.05)。与本组术前比较,2组术后3天、1个月、6个月ODI评分均降低(P<0.05),但2组术后3天、1个月、6个月ODI评分组间比较差异均无统计学意义(P>0.05)。结论PVP联合小针刀松解治疗OVCF合并肋间痛疗效确切,可有效缓解患者胸背及肋间疼痛症状,改善腰椎功能,其中在治疗早期肋间疼痛方面效果更显著,安全可靠。

Objective To observe the clinical effect of percutaneous vertebroplasty(PVP)combined with small needle knife release for intercostal pain after surgery of osteoporotic vertebral compression fracture(OVCF).Methods Totally 63 patients with intercostal pain after surgery of OVCF were randomly assigned to the control group(n=28)and the treatment group(n=35).Patients in the control group and the treatment group were treated with PVP and small needle knife release combined with PVP,respectively.The visual analogue score(VAS)and Oswestry Disability Index(ODI)score were recorded to evaluate the chest,back and intercostal pain,and lumbar function at the following four time points:before treatment,day 3 and months 1,6 of post-operation.Results VAS scores for chest,back and intercostal pain on day 3,and months 1 and 6 of post-operation in the treatment group were significantly lower than before its pre-operation(all P<0.05).VAS scores for chest and back pain on day 3,and months 1 and 6 of post-operation in the control group were significantly lower than before its pre-operation;and VAS scores for intercostal pain on month 6 in the control group were significantly reduced(all P<0.05).VAS scores for intercostal pain on day 3,and month 1 of post-operation of the treatment group were significantly lower than those of the control group(both P<0.05).The difference was not statistically significant in VAS scores for chest and back pain on day 3,and months 1 and 6 of post-operation,as well as VAS scores for intercostal pain on month 6 of post-operation between groups(P>0.05).Compared with before treatment,ODI scores on day 3,and months 1 and 6 of post-operation in the both groups were significantly reduced(all P<0.05).No significant differences were detected in ODI scores on day 3,and months 1 and 6 of post-operation between groups(all P>0.05).Conclusion For patients with intercostal pain after surgery of OVCF,PVP combined with small needle knife release has definite curative effect,can effectively relieve chest,back and intercostal pain,and improve lumbar function,which is effective in relieving intercostal pain in the early-stage after the surgery with an acceptable safety.